The Psychological Factor in Return to Sport following ACL Reconstruction

Following reconstruction of the ACL, there is a level of fear associated with re-injury. Not only does this anxiety increase injury risk, but it also lowers the level of performance. The Chicago Bulls' Derrick Rose has been under criticism, regarding this issue. In April 2012, Rose tore his ACL and went on to have surgery about a month later. Around March of 2013, his surgeon said he was medically cleared to play. Rose then went back and forth about being ready to play until the playoffs were over. His reason for hesitancy was lack of confidence in his surgical leg. Physiospot did a review of some research on this topic. It was found that only 31% of athletes return to pre-injury level of play at 12 months. An association was found between pre-surgery/early rehab psychological response and return to pre-injury levels at 12 months. We should take two things away from this: at this point, it is the exception, not the rule, that athletes return at pre-injury levels at 12 months or fewer, and we should be assessing the psychological component in rehab more often. Another item to point out, is the fact that we, as a health care system, are lacking any truly valid return to play criteria for ACL reconstruction. Many surgeons/physical therapists use things like isokinetic strength testing compared to the uninvolved limb, but as you can see by the 31% level of return, there is a discrepancy between isokinetic strength and actual competitive play.

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